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SUBSCRIBER SURVEY
A subscriber survey will be mailed out by OU on 09/20/2010. Please notify your groups
that if one of their employees receive a survey to fill out the survey and return by
10/22/2010.
DEPENDANTS
Foster Children - Even though foster children may be counted on the taxes, they are not
considered dependents in the Insure Oklahoma program for ESI or IP. The foster care
income does not count against the household. They do not need to list the foster children
and foster care income on the application.
OUT-OF-POCKET - COVERED IN-NETWORK SERVICES
Insure Oklahoma does reimburse certain out-of-pocket expenses that exceed 5% of the
household income. In order to be eligible to receive reimbursement, the expenses have
to exceed the 5% limit, the expenses must be for covered in-network services and the
expenses must be for the member that is approved for Insure Oklahoma.
CHANGE IN FEIN AND QHP
FEIN – must submit a new 2 page application and must be compliant with the OESC.
QHP- must submit a new 2 page application, rates, and a benefit summary page.
EMPLOYER CHANGE FORM
Please inform employers if there are changes in the new hires, change in employer con-tact
information, or terminated employees. Please fill out the Employer Change Form and
fax to 405-530-3433 or email to insureok@okhca.org
Insure Oklahoma Agent Blast - 9/2010

SUBSCRIBER SURVEY
A subscriber survey will be mailed out by OU on 09/20/2010. Please notify your groups
that if one of their employees receive a survey to fill out the survey and return by
10/22/2010.
DEPENDANTS
Foster Children - Even though foster children may be counted on the taxes, they are not
considered dependents in the Insure Oklahoma program for ESI or IP. The foster care
income does not count against the household. They do not need to list the foster children
and foster care income on the application.
OUT-OF-POCKET - COVERED IN-NETWORK SERVICES
Insure Oklahoma does reimburse certain out-of-pocket expenses that exceed 5% of the
household income. In order to be eligible to receive reimbursement, the expenses have
to exceed the 5% limit, the expenses must be for covered in-network services and the
expenses must be for the member that is approved for Insure Oklahoma.
CHANGE IN FEIN AND QHP
FEIN – must submit a new 2 page application and must be compliant with the OESC.
QHP- must submit a new 2 page application, rates, and a benefit summary page.
EMPLOYER CHANGE FORM
Please inform employers if there are changes in the new hires, change in employer con-tact
information, or terminated employees. Please fill out the Employer Change Form and
fax to 405-530-3433 or email to insureok@okhca.org
Insure Oklahoma Agent Blast - 9/2010